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1922512441
FREDRICK GILLAM
CORDOVA, TN
NPI
1922512441
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: TN 0000003668)
Enumeration Date
2017-11-20
Last Update Date
2017-11-20
Business Address
Mr. FREDRICK GILLAM LPC-MHSP
815 EXOCET DR STE 107
CORDOVA, TN 38018-2257
Phone number: 901-230-2409
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Mailing Address
Mr. FREDRICK GILLAM LPC-MHSP
PO BOX 2911
CORDOVA, TN 38088-2911
Phone number: 901-230-2409
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